Provider Demographics
NPI:1942671052
Name:TOWERS, KRISTYN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTYN
Middle Name:
Last Name:TOWERS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 CIRBY WAY
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-5520
Mailing Address - Country:US
Mailing Address - Phone:916-786-2970
Mailing Address - Fax:
Practice Address - Street 1:1750 CIRBY WAY
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-5520
Practice Address - Country:US
Practice Address - Phone:916-786-2970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-14
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT114990106H00000X
CAIMF89172106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA106H00000XMedicaid